Intraoperative Cranial Nerve Monitoring in Otolaryngology-Head and Neck Surgery

Part I: Nerve Monitoring Principles.- Historical Perspective on Nerve Monitoring during Head and Neck Surgery.- Basic and Advanced Electrophysiology.- Anesthesia Considerations and Set-up.- Neural Injury Mechanisms.- Education.

 

Part II: Vagus/Recurrent Laryngeal Nerve Monitoring.- Rationale and Indications for Vagus/Recurrent Laryngeal Nerve Monitoring.- methods for Vagus/Recurrent Nerve Monitoring.- Monitoring of the Superior Laryngeal Nerve.- Continuous Intraoperative Neuromonitoring (CIONM).- Emerging Trends for Vagus/Recurrent Laryngeal Nerve Monitoring.- Troubleshooting System Integrity.- Managing Loss of Signal.- Incorporating Never Monitoring into the Intraoperative Management of Invasive Thyroid Cancer.- Nerve Monitoring in Remote Access Thyroid Surgery.- Nerve Monitoring in Parathyroid Surgery.

 

Part III: Facial Nerve, Glossopharyngeal Nerve, Hypoglossal Nerve Monitoring.- Facial Nerve Monitoring, Extratemporal Facial Nerve.- Spinal Accessory Nerve Monitoring.- Glossopharyngeal Nerve and Hypoglosssal Nerve Monitoring.

 

Part IV: Miscellaneous Nerve Monitoring Considerations.- Documentation and Reimbursement.- Ethical Considerations in Nerve Monitoring.- Nerve Monitoring and Medical Malpractice.

This book covers the scope of cranial nerve monitoring of all cranial nerves that are of practical importance in head, neck, and thyroid surgery. It discussed enhanced patient outcomes in a wide array of surgical procedures in the head and neck that require the maintenance of complex regional functions by protecting cranial nerve integrity.

 

Organized into four parts, the book begins with Part I offering historical perspectives on the subject while simultaneously reviewing various basic and advanced electrophysiology. Part II thoroughly reviews the extra-temporal bone facial nerve (CN VII), Glossopharyngeal Nerve (CN IX), Vagal/Recurrent Laryngeal Nerve (CN X), Spinal Accessory Nerve (CN XI), and Hypoglossal Nerve (CN XII). Subsequent chapters in Part III provide a complete and applied understanding of the neurophysiological principles that facilitate the surgeon’s ability to monitor any nerve and intraoperative neural stimulation and nerve monitoring. The book presents various techniques as the standard of care to provide optimal neural detection, understand the neural functional real-time status during surgery and optimize specific surgical outcomes such as thyroid surgical outcomes. Closing chapters offer essential conversations regarding ethical considerations in nerve monitoring and medical malpractice.

 

Filling a gap in the literature, Intraoperative Cranial Nerve Monitoring in Otolaryngology: Head and Neck Surgery provides a single source for surgeons who wish to optimize their outcomes in patient care and accelerate their learning curve to the level of more experienced surgeons.

 

Contributor Bio(s)

Joseph Scharpf, MD, FACS

Director of Head and Neck Endocrine Surgery

Head and Neck Institute

Cleveland Clinic Foundation

Cleveland, Ohio

Gregory W. Randolph, MD, FACS, FACE, FEBS (Endocrine)

Professor of Otolaryngology Head and Neck Surgery,

Harvard Medical School

Division of Thyroid and Parathyroid Endocrine Surgery